Is intravenous immunoglobulin a risk factor for necrotizing enterocolitis in neonates with haemolytic disease of the newborn? A retrospective cohort study

Vox Sang. 2022 Sep;117(9):1098-1104. doi: 10.1111/vox.13297. Epub 2022 May 25.

Abstract

Background and objectives: To assess whether the use of intravenous immunoglobulin (IVIG) in late-preterm and term newborns with haemolytic disease of the newborn (HDN) is associated with an increased risk of necrotizing enterocolitis (NEC).

Materials and methods: A retrospective cohort study was conducted in a tertiary centre. Infants with HDN during early neonatal period (<7 days) who were of ≥34 weeks' gestation and born between January 2019 and October 2021 were included. Propensity score, interaction as well as univariate and multiple logistic regression analyses were employed.

Results: One-thousand two-hundred and fifty-nine infants with HDN were enrolled, of whom 192 (15.3%) received IVIG. NEC was diagnosed in 29 (2.3%) patients with 5 (2.6%) in the IVIG group and 24 (2.2%) in the non-IVIG group. No significant association between IVIG administration and confirmed NEC was observed using univariate analysis (p > 0.05). The possible predictors of NEC, as assessed by multivariate analysis, were caesarean delivery, haemoglobin on admission <130 g/L and patent ductus arteriosus (PDA). There was no interactive effect of IVIG against NEC for prematurity, low birth weight, caesarean delivery, haemoglobin on admission <130 g/L and PDA.

Conclusions: In late-preterm and term infants with HDN, there was no evidence that the early use of IVIG led to the development of NEC.

Keywords: haemolytic disease of the newborn; intravenous immunoglobulin; necrotizing enterocolitis; risk factor.

MeSH terms

  • Enterocolitis, Necrotizing*
  • Erythroblastosis, Fetal*
  • Female
  • Humans
  • Immunoglobulins, Intravenous / adverse effects
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Pregnancy
  • Retrospective Studies
  • Risk Factors

Substances

  • Immunoglobulins, Intravenous